For secundum ASD, a deficient retro-aortic rim is common (40% of cases) However, the deficient retro-aortic rim had no effect on ASD device placement success or immediate outcome The IMPACT Registry does not track long-term outcome, so there is no information provided about long-term complications, such as erosion.

In the presence of a patent foramen ovale (PFO), a transient ischemic attack is indistinguishable from a complex migraine. Both have transient neurologic deficits with a normal MRI. The size of a PFO by echo should not be a criterion for closure. A stroke or peripheral embolus associated with a PFO is the indication for closure. Informed consent for PFO closure should include the warning that about 1 in 500 cases require device removal through open-heart surgery.

In patients who have a cryptogenic stroke and have their PFO closed, the recurrence rate of "cerebral ischemia" is much greater in patients who are older than 55 years. Most of these recurrent events (2 strokes and 4TIAs) in the older age group were due to identifiable causes. These findings corroborate the long-term results from the RESPECT randomized clinical trial of PFO closure versus medical therapy.

Over 21 years, 26 coronary artery fistulae were treated percutaneously, and 21 (81%) were successful. There is still much to be learned about the physiology of coronary fistulae. Transcatheter methods have improved over the years and permit a high success rate, but some cases still require a surgical approach.